Study on the correlation between red blood cell volume distribution width and protein energy wasting in maintenance hemodialysis patients / 中国实用内科杂志

ABSTRACT

OBJECTIVE: To study the relationship between red blood cell volume distribution width(RDW)and protein energy wasting(PEW)in maintenance hemodialysis(MHD)patients. METHODS: A multicenter cross-sectional study was conducted in eight hemodialysis centers of Guizhou province in 2018.Clinical data,laboratory values,physical parameters and body composition data of MHD patients were collected. According to the quartile of RDW,the patients were divided into four groups. The differences in the indexes among the 4 groups were compared.Logistic regression models were used to analyze the relationships between RDW and the occurance of PEW. The receiver operating characteristic curves(ROC)was applied to evaluate the predictive power of RDW for PEW. RESULTS: Totally 594 MHD patients were enrolled and were divided into 4 groups,value according to RDW quartile(Q1,Q2,Q3 and Q4). Logistic regression analysis showed that the occurance of PEW was correlated with RDW in MHD patients. The risk of PEW in MHD Q4 group was 2.583 times higher than that of the Q1 group(95%CI 1.588-4.202, P<0.001). After adjustment for patients' age, gender, DM history,dialysis age,hemoglobin, serum phosphorus, serum alanine aminotransferase and aspartate aminotransferase,the risk of Q4 group was 2.197 fold higher than that of Q1 group(95%CI 1.306-3.698, P<0.005). Recover operating characteristic(ROC)analysis showed that the optimal threshold for predicting PEW risks in MHD patients was 15.6% with a sensitivity and specificity of 40.35% and78.72% respectively and the area under curve was 0.611(95%CI 0.570-0.650,P<0.0001). CONCLUSION:s For MHD patients,RDW is associated with the occurance of PEW and has the value for PEW.